Region 7 NC Minority Diabetes Prevention Program

Register

Please fill out the information below. Your name and email address are required. Once you submit your information, a coach will contact you.

First Name *

Last Name *

Email *

Phone

Race

Ethnicity

Age

Insurance Provider

Language

Preferences for Attending the Program

Distance Learning
(program delivered through a virtual classroom via internet on a computer, tablet, or phone, with a live coach at scheduled times)

In-Person
(physically present at a location, with a coach and other group members at scheduled time)

Online
(program delivered via internet on a computer, tablet, or phone, completing sessions at your own schedule)

Day Preferences

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Time Preferences

Morning

Afternoon

Evening

* Required

AIM High Keep Pressing

El Centro Hispano

Granville Vance Public Health

Henderson YMCA

Johnston County Health Department

Wake County Health Department

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